Medicare beneficiaries in markets characterized by high service use did not report better experiences with care. This trend was strongest for those in managed care.

More intensive medicine involves relatively more capital and less labor in the provision of medical services. If more labor inputs are correlated with higher patient satisfaction scores, areas with less intensive medical care may benefit in the rankings due to longer patient-physician interactions. Whether or not the marginal value of an additional unit of capital compared to labor is most beneficial to health outcomes, however, has yet to be determined.